The health insurance trade group conducted an industrywide survey on prior authorization practices and gold carding experiences of commercial plans between February and April. AHIP received responses from 26 plans covering 122 million commercial enrollees.
The most common treatments subject to PA:
- Genetic testing: 100 percent
- Specialty drugs: 100 percent
- Elective inpatient surgical services: 92 percent
- Election inpatient medical services: 88 percent
- High cost non-specialty prescription drugs: 88 percent
- High-tech imaging: 88 percent
- Post acute care facility services: 88 percent
- Cardiology: 80 percent
- Durable medical equipment: 80 percent
- Orthopedics: 80 percent
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.